A swelling in the leg

A swelling in the leg

1. Anatomy

   • Anterior compartment
     • quadriceps femoris insert through the patella
       • patella functions
         • Leg extension
         • protection of knee joint
         • patellar dislocation occurs laterally
   • posterior compartment
     • blood supply
       • sciatic artery
       • 1st, 2nd, 3rd perforating arteries
     • popliteal fossa bony landmarks
     • popliteal fossa
       • contents
         • Popliteal artery. & its brs.
         • Popliteal vein & its tributaries.
         • Medial popliteal (tibial) n. & its brs.
         • Lateral popliteal (common peroneal) n. & its brs.
         • Popliteal lymph nodes
         • Fat

2. bone tumors

   • abnormal growth and division of bone cells
     • malignant
       • invades tissues and metastasizes
         • primary
           • arises from bone cells
         • secondary
           • metastasized and spread to bone
     • benign
       • confined and doesnt spread
   • types
     • bone forming (osteoblastic tumors)
     • cartilage forming tumors
     • miscalleneous tumors
     • myelogenic tumors
     • fibrogenic tumors
     • histocytic origin
     • notochordal tumor
     • vascular tumors
     • lipogenic tumors
     • neurogenic tumors

3. osteosarcoma

   • bone cancer that usually develops in the osteoblast cells that form bone.
   • can be secondary or primary
   • more common in males
   • metaphysis of long bones (mostly around knee
   • large bulky greyish white mass
   • sun-burst appearance
     • due to mutation in retinoblastoma gene
   • treatment
     • surgery
       • surgeon removes the entire tumor with negative margins
     • chemotherapy
       • use of anticancer drugs to kill cancer cells.
     • radiotherapy
       • use of high-energy x-rays to kill cancer cells
     • cryotherapy
       • Cryosurgery is the use of liquid nitrogen to freeze and kill cancer cells.
     • targeted therapy
       • use of a drug that is designed to interact with a specific molecule involved in the growth and spread of cancer cells.

4. ethics and psychosocial aspect

   • informed consent
     • significance
       • documentation helps avoid legal repercussions on both sides.
       • allows for educated and voluntary decision making.
     • It is communication between a patient and a healthcare professional that often leads to documentation of the patient’s decision about the performance of a procedure.
       • contains
         • Alternatives + their risks and benefits
         • Risks and benefits of the procedure.
         • An explanation of the medical condition and the procedure to be performed.
   • adolescent reaction to illness
     • body image issues
       • E.g - visible surgical scars.
     • Interferes with a teen's comfort in becoming less dependent on parents
     • Illness interfere with time spent with peers or in the school setting.
     • Anxiety regarding relapse

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